Left atrial dilatation: A cohort analysis with strong implications for future atrial fibrillation and stroke monitoring

Introduction: Atrial fibrillation (AF) increases the risk of thromboembolism five-fold. Left atrial dilatation (LAD) is a known predictor of AF. It is necessary to better understand the association of LAD, AF and stroke to determine if screening with cardiac monitoring as a prevention measure for stroke is potentially warranted in patients with LAD and no history of cryptogenic stroke. Aim: To evaluate the high risk association of LAD on routine echocardiography with AF and stroke. Methods: A retrospective review of all patients with an echocardiogram performed within Henry Ford Health System from Mar 6th to Sept 6th 2016 was conducted. Patients were categorized based on the degree of LAD (mild, moderate and severe). Chisquared tests and two-sample t-tests were used to compare characteristics and multivariate logistic regression analyses were done with AF and stroke as outcomes in two separate models adjusting for the exposure variables. Results: From a total of 8679 patients, 54% were female and 41% were African American. The mean age was 64.9 years (SD=16.9). Patients were divided into normal LA size (55%), mild LAD (15%), moderate LAD (12%) and severe LAD (18%). Patients with any LAD were older (70.7±15.0 vs 60.1±17.0